# JESUS ALFONSO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386824308
- **Authorized official:** DR. JESUS ALFONSO MD (OWNER)
- **Authorized official phone:** (201) 330-8747

## Contact information

- **Practice address:** 7907 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4137
- **Practice address phone:** (201) 330-8747
- **Practice address fax:** (201) 330-8947
- **Mailing address:** 7907 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4137
- **Mailing address phone:** (201) 330-8747
- **Mailing address fax:** (201) 330-8947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 25MA05064100 | NJ | Yes |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 11/07/2007